ED adds inpatient pediatric beds
Children admitted as inpatients from Carilion Radford Community Hospital's ED (VA) will be transported only as far as across the hall. "We're adding five inpatient beds to the four ED pediatric-designated beds we currently have," reports Alan Vierling, RN, CEN, the hospital's director of emergency services. "This will change how we deliver care to children, and improve the overall continuity of care."
Five pediatric nurses care for children from the moment they come to the ED and during their entire stay if they are admitted. The nurses have received extensive education including pediatric critical care, PALS, and TNCC, says Vierling.
The arrangement will provide seamless care, Vierling says. "Now if a child gets admitted, they will simply be rolled across the hall to become an inpatient," he explains. "The child won't have to become familiar with a brand new set of caregivers."
Many steps in the admitting process are eliminated, Vierling notes. "Now, the mom doesn't have to explain the child's medical history to another group of people upstairs or explain what they did downstairs in the ED, because the same exact nurses will continue to care for the child," he says.
Although the ED, which has 23,000 visits per year, doesn't have a large volume of pediatric patients, a need was identified. "For a rural hospital, this is a big commitment," Vierling says. "It's true that we don't see as much pediatric volume as a major children's hospital. On the other hand, it's about 30% of our business, so we have a clear responsibility to focus on pediatric patients."
Length of stay is likely to decrease, Vierling predicts. "If a child is put on an asthma pathway and the same nurse that takes care of the patient initially follows through, the child will be further along more quickly because there is no break in care," he says. "This streamlines the process exponentially."
Community pediatricians appreciate the fact that the same nurses are caring for their patients throughout their stay, Vierling notes. "They were always familiar with our ED nurses, but this allows that relationship to be even tighter," he says. "A single nurse can explain how the child responded during his or her entire stay."
Previously, the med/surg nurses who cared for children as inpatients saw pediatric patients only occasionally, says Vierling. "This way, if our pediatric inpatient volume dies, our staff is still going to get plenty of pediatric experience because they're doing all the outpatients in the ED. That way, their level of skills stays sharp."
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